Provider Demographics
NPI:1881673093
Name:PARE', BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:
Last Name:PARE'
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 N MOUNT JULIET RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3078
Mailing Address - Country:US
Mailing Address - Phone:615-758-5672
Mailing Address - Fax:615-758-5609
Practice Address - Street 1:3500 N MOUNT JULIET RD
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3078
Practice Address - Country:US
Practice Address - Phone:615-758-5672
Practice Address - Fax:615-758-5609
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD14262207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3196849Medicaid
TN3196842Medicare ID - Type UnspecifiedMEDICARE NUMBER
TN3196849Medicaid